A report released in June by the World Health Organization (WHO) and the World Bank estimates that more than a billion people worldwide, 54 million of whom live in the United States, experience some form of disability.

The World Report on Disability indicates that people with disabilities are more than twice as likely to find health care provider skills inadequate to meet their needs, and nearly three times more likely to report being denied needed health care. In low-income countries, people with disabilities are 50% more likely to experience expenditures related to catastrophic health conditions than people who have no impairment. Children with disabilities are less likely to start and stay in school.

The report includes information on health, rehabilitation, assistance and support, enabling environments, education, and employment, and highlights a range of good practice examples in each area that help establish an inclusive and enabling society in which people with disabilities can flourish. Key findings include:

A paradigm shift away from a medical understanding toward a social understanding in approaches to disability. Disability arises from the interaction between a person with a health condition and the person’s environment. Inclusion is enhanced when environmental barriers are removed.

A high and growing prevalence of disability, with more than a billion people (15% of the world population) with disabilities around the globe. Of those, 110–190 million experience very significant difficulties. Prevalence is growing due to population aging and a global increase in chronic health conditions. Patterns of disability in a particular country are influenced by trends in health conditions and environmental and other factors, such as traffic crashes, natural disasters, conflict, diet, and substance abuse.

Vulnerable populations are disproportionately affected by disability, which is more common among women, older people, and households that are poor. Lower-income countries have a higher prevalence of disability than higher-income countries.

Disability is diverse, and the experience varies greatly. Although disability correlates with disadvantage, not all people with disabilities are disadvantaged equally. School enrollment rates differ—children with physical impairments generally fare better than those with intellectual or sensory impairments. Those most excluded from the labor market are often those with mental health difficulties or intellectual impairments. People with more severe impairments often experience greater disadvantage.

People with disabilities face widespread barriers accessing services (health, education, employment, transportation, information), including inadequate policies and standards; negative attitudes; inadequate funding and information/communication; and lack of service provision, accessibility, and participation in decisions that directly affect their lives.

People with disabilities have worse health, education, and socioeconomic outcomes. Many of the barriers faced by people with disabilities are avoidable and the disadvantage associated with disability can be overcome.

The report also includes recommendations based on these findings:

Enable access to all mainstream systems and services. Mainstreaming is the process by which governments and other stakeholders address the barriers that exclude persons with disabilities from participating equally in any service intended for the general public. Mainstreaming requires changes to laws, policies, institutions, and environments. It not only fulfills the human rights of persons with disabilities, it also can be more cost-effective.

Invest in programs and services for people with disabilities. Some people with disabilities may require access to specific resources, such as rehabilitation, support services, or vocational training.

Adopt a national strategy and plan of action. All stakeholders should collaborate on a strategy to improve the well-being of people with disabilities that includes coordination between sectors and services and close monitoring of progress.

Involve people with disabilities in formulating and implementing policies, laws, and services. Persons with disabilities are entitled to have control over their lives and need to have input on issues that concern them directly.

Improve human resource capacity through effective education, training, and recruitment. Training of health professionals, architects, and designers, for example, should include relevant content on disability and be based on human rights principles.

Provide adequate funding of public services to remove financial barriers to access and ensure that high-quality services are provided.

Increase public awareness and understanding. It is vital to improve public understanding of disability, confront negative perceptions, and represent disability fairly.

Improve the availability and quality of data on disability. Data need to be standardized and internationally comparable to benchmark and monitor progress on disability policies nationally and internationally.

Strengthen research on disability. More research is needed, not just about the lives of people with disabilities, but also about social barriers and how they can be overcome.